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在巴西东南部的一个转诊诊断中心,通过双扩散免疫试验筛查球孢子菌病:一种易于使用的工具。

Screening paracoccidioidomycosis by double immunodiffusion test in a referred diagnostic center in Brazilian southeastern: an accessible tool.

机构信息

Center for Research in Medical Mycology, Pathology Department, Federal University of Espírito Santo (UFES), Vitória, Brazil.

Medical Clinical Department, Federal University of Espírito Santo (UFES), Vitória, Brazil.

出版信息

Infection. 2021 Dec;49(6):1257-1264. doi: 10.1007/s15010-021-01704-8. Epub 2021 Sep 28.

Abstract

PURPOSE

This article shows reports of the clinical-epidemiological characteristics and serological screening in patients assisted by a reference center for PCM care, University Hospital Cassiano Antonio Moraes, Federal University of Espirito Santo, Brazil.

METHODS

The patient's sera with PCM were analyzed by DID test at the beginning and the end treatment. Clinical and demographic data were also collected to characterize the sample.

RESULTS

One hundred patients with a suspected diagnosis of PCM were evaluated. Serology by DID test was used as a screen in all patients. The test was positive for 79 patients (72 for Paracoccidioides brasiliensis and 7 for Paracoccidioides lutzii). Serology was negative in 21 sera, although all of them were diagnosed PCM by histopathologic or direct exam. Serological follow-up was performed during the treatment of all patients. After treatment, 58(58%) had negative serology and 33(33%) low levels of antibodies (≤ 1:16).

CONCLUSION

Our results indicate the importance of the DID test for the screening and monitoring of PCM and that the incidence of P. lutzii might be greater than expected in areas where it is not the predominant PCM species. Therefore, this article may contribute to improving the knowledge and clinical management about this disease.

摘要

目的

本文展示了巴西圣埃斯皮里图联邦大学卡西亚诺·安东尼奥·莫拉埃斯参考中心为 PCM 患者提供的临床流行病学特征和血清学筛查报告。

方法

在开始和结束治疗时,使用 DID 试验对 PCM 患者的血清进行分析。还收集了临床和人口统计学数据来描述样本。

结果

评估了 100 例疑似 PCM 的患者。DID 试验血清学检查被用于所有患者的筛查。79 例患者(72 例为巴西副球孢子菌,7 例为卢氏副球孢子菌)的检测结果为阳性。21 份血清学检测结果为阴性,但所有患者均通过组织病理学或直接检查诊断为 PCM。对所有患者均进行了血清学随访。治疗后,58 例(58%)患者的血清学检测结果为阴性,33 例(33%)患者的抗体水平较低(≤1:16)。

结论

我们的结果表明 DID 试验对 PCM 的筛查和监测具有重要意义,且在并非主要流行的 PCM 种的地区,卢氏副球孢子菌的发病率可能高于预期。因此,本文可能有助于提高对这种疾病的认识和临床管理水平。

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